Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood最新文献

{"title":"The internal anal sphincter in anorectal malformation.","authors":"K Ohama, S Asano, K Nanbu, T Kajimoto","doi":"10.1055/s-2008-1042575","DOIUrl":"https://doi.org/10.1055/s-2008-1042575","url":null,"abstract":"Recently it has been morphologically clarified that a layer of thick smooth muscle, mimicking the internal anal sphincter, exists at the rectal and even in high and intermediate anorectal malformations. This paper will describe two studies focussed on the internal anal sphincter in anorectal malformation. I. Experimental study: Utilisation of the rectal end for reconstructive surgery would necessitate the mobilisation of the rectum. We performed a chronic animal experiment in order to investigate the influence of rectal mobilisation on anal function and the role of the internal anal sphincter in anal continence. Fifteen dogs were operated on; rectal separation was performed in 5 dogs, resection of the internal anal sphincter in 5 dogs and both procedures in 5 dogs. Anorectal manometric studies for 24 weeks revealed that rectal separation caused only a transient mild disturbance in anal functions with the exception of long-standing high rectal compliance, while resection of the internal anal sphincter caused a persistent severe disturbance. II. Clinical study: The function of the smooth muscle thickening at the rectal end was investigated and operations to preserve the rectal end were evaluated in cases of high and intermediate anorectal malformations. In 5 infants with anorectal malformations (high type 2, intermediate type 3), for whom colostomies had been performed as newborn, a preoperative manometric study at the rectal end was performed with a probe introduced from the distal colostomy. Thereafter, they all underwent a rectal end preserving operation. They were followed up manometrically and clinically after the operation. A preoperative manometric study of the rectal end showed the presence of rhythmic activity in all and positive reflexive pressure fall by rectal distension in 4. The rectal end preserving operation maintained rhythmic activity in all of them, rectoanal reflex in 3 and good results are expected clinically. These two studies suggest that the functional internal anal sphincter, which exists at the rectal end also in high and intermediate anorectal malformations, should be utilised for reconstruction because of the essential role it plays in anal continence.","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"167-77"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13525828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Congenital laryngeal chondroma: an unusual cause of congenital stridor].","authors":"P Gundlach,&nbsp;C Radke,&nbsp;J Waldschmidt","doi":"10.1055/s-2008-1042577","DOIUrl":"https://doi.org/10.1055/s-2008-1042577","url":null,"abstract":"<p><p>Tumours originating from the laryngeal skeleton are a rarity. They occur in most cases in adults aged between 40 and 60 years and are seen four times more often in males than in females. A case study of a congenital chondroma of the larynx is presented that resulted in a connatal stridor. It is emphasised that chondromas of the larynx should be considered in differential diagnosis of congenital anomalies of the larynx. Early excision of the complete tumour with minimal destruction of the adjacent laryngeal tissues is recommended as the treatment of choice.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"182-4"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13525830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the reduction of VIP the clue to the pathophysiology of Hirschsprung's disease?","authors":"L T Larsson,&nbsp;F Sundler","doi":"10.1055/s-2008-1042574","DOIUrl":"https://doi.org/10.1055/s-2008-1042574","url":null,"abstract":"<p><p>The reduction of vasoactive intestinal peptide-(VIP) containing nerve fibres in the aganglionic segment in Hirschsprung's disease is thought to contribute to the sustained contraction of this intestinal segment. In order to study the significance of VIP in the pathogenesis of Hirschsprung's disease we used immunohistochemistry to evaluate the reduction of VIP-immunoreactive nerve fibres in aganglionic intestine compared to the ganglionic one. The VIP nerve fiber density was compared with the type of onset of disease (e.g. neonatal ileus or obstipation) and with the length of the aganglionic segment. No statistically significant correlation between these factors could be registered. This indicates a high complexity of the neuronal derangement in aganglionic intestine and that the degree of VIP deficiency alone does not correlate with the severity of the disease.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"164-6"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042574","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13523661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty-six early operations in brachial birth palsy.","authors":"M Alanen,&nbsp;S Ryöppy,&nbsp;T Varho","doi":"10.1055/s-2008-1042566","DOIUrl":"https://doi.org/10.1055/s-2008-1042566","url":null,"abstract":"<p><p>26 babies with brachial birth palsy were operated on at the age of 12-275 days (mean 75 days) in paediatric surgical departments of Helsinki (12 cases) and Turku (14 cases) University Central Hospitals during years 1970-1985 using microsurgical techniques. Epineuroraphy was used in 9, interfascicular nerve grafting in 7, neurolysis in 7, and intercostal neurotisation in 3 cases. The functional status of the upper extremity was recorded 1 to 14 years after the operation using a modified Mallet's classification: 6 were good, 17 fair and 3 poor. The outcome after epineuroraphy was similar to interfascicular grafting. One intercostal neurotisation resulted in fair function and 2 in poor, but the result in target function, i.g. in the peripheral neurotised nerve, was good.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"136-9"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13523655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catamnestic investigations in children with congenital hydrocephalus.","authors":"T A Angerpointner,&nbsp;L Pockrandt,&nbsp;K Schroer","doi":"10.1055/s-2008-1042571","DOIUrl":"https://doi.org/10.1055/s-2008-1042571","url":null,"abstract":"<p><p>Catamnestic investigations on the course of pregnancy, family history and genetics were carried out in 141 children suffering from congenital hydrocephalus. The results were compared with those obtained from a group of non-malformed controls investigated by the same criteria. There was a considerably higher incidence of pregnancy disturbances (i.e. diseases, drugs, haemorrhage etc.) in mothers who later gave birth to a child with congenital hydrocephalus, than mothers of the control group (congenital hydrocephalus: 61.3% vs. controls: 30.1%). This high incidence of pregnancy disturbances could be particularly referred to a sevenfold increased rate of diseases and a fourfold increased rate of drug intake during the first trimester. There was also a higher rate of malformed relatives in children with congenital hydrocephalus (16.7%) than in controls (6.4%); not only were malformations of the central nervous system found to be increased but also malformations of other organ systems in relatives. This is interpreted as a hint not only at genetic influences but also at a generally higher incidence of malformations in a relatively small group of persons. Calculated figures of recurrence risk were in accordance with empirical data used in genetic counselling.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"151-5"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042571","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13523658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography and magnetic resonance tomography findings in children operated for anal atresia.","authors":"E Arnbjörnsson,&nbsp;N Malmgren,&nbsp;C Mikaelsson,&nbsp;S Laurin,&nbsp;L Okmian","doi":"10.1055/s-2008-1042576","DOIUrl":"https://doi.org/10.1055/s-2008-1042576","url":null,"abstract":"<p><p>Computerised tomography and magnetic resonance tomography were performed in nine faecally incontinent patients more than eight years after rectoplasty for high imperforate anus. No statistically significant correlation was found between function, i.e. degree of faecal incontinence, and anatomical findings. Thus, in spite of a detailed demonstration of the post-operative anatomy, the information does not seem to be directly applicable in indicating a way to reoperate for faecal incontinence in this group of patients.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"178-81"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13525829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portal vein thrombosis of the adolescent: indications for autologous internal jugular vein interposition meso-caval shunt.","authors":"F Mosimann,&nbsp;D Berger,&nbsp;P F Cuénoud,&nbsp;R Mosimann","doi":"10.1055/s-2008-1042579","DOIUrl":"https://doi.org/10.1055/s-2008-1042579","url":null,"abstract":"<p><p>Endoscopic sclerotherapy is now the treatment of first choice for oesophageal varices. However, in spite of its efficiency and safety, recurrent bleeding remains possible and oesophageal sclerosis does not cure other potentially incapacitating symptoms related to portal hypertension. This report describes four adolescents with prehepatic hypertension for whom sclerotherapy was inadequate. They were treated successfully by an autologous internal jugular vein interposition mesocaval shunt. This operation is safe, decompresses the whole splanchnic territory and obviates the need for long term endoscopic surveillance.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"189-91"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042579","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13525832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scintigraphy with 99mTc-HIDA in assessment of the postoperative course after traumatic lesions of the liver and biliary tract.","authors":"L Rasmussen,&nbsp;E Oster-Jörgensen,&nbsp;C P Hovendal,&nbsp;N Qvist,&nbsp;S A Pedersen","doi":"10.1055/s-2008-1042567","DOIUrl":"https://doi.org/10.1055/s-2008-1042567","url":null,"abstract":"<p><p>99mTc-HIDA scintigraphy was used as a diagnostic procedure in five children with liver and biliary tract injuries following blunt abdominal trauma. The method was used in patients after surgical intervention. The children fell into three groups. The first, focal reduction in activity with or without extravasation. The second, normal hepatic parenchymal phase with extravasation. The third, increased focal activity (biloma). We concluded that the use of 99mTc-HIDA scintigraphy supplies important information in the diagnostic work-up and informs about the proper time for removal of T-tube drainage. This method is also recommended preoperatively in children who are clinically stable and in whom trauma to the liver and biliary tract is suspected.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 3","pages":"140-3"},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13270177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Course of pregnancy, family history and genetics in children with spina bifida.","authors":"T A Angerpointner,&nbsp;L Pockrandt,&nbsp;K Schroer","doi":"10.1055/s-2008-1042554","DOIUrl":"https://doi.org/10.1055/s-2008-1042554","url":null,"abstract":"<p><p>Course of pregnancy, family history and genetics were evaluated in 257 children with spina bifida and compared with 537 non-malformed controls investigated under the same criteria. Birth data exhibited a significant seasonality with a maximum in January and a minimum in July which differed from the average distribution of birth data in Bavaria (maximum April, minimum October). The total number of pregnancy disturbances was 60.6% in mothers of spina bifida children, whereas this figure amounted to 30.1% in mothers of the control group. This high incidence of pregnancy disturbances in spina bifida was due to a high rate of diseases (6 times above controls) and drugs (6 times above controls) during early pregnancy. In 22.9% of children with spina bifida malformed relatives were found, whereas this was the case in only 6.4% of the children of the non-malformed control group. Not only malformations of the central nervous system but also malformations of other organ systems were found to be increased in relatives. This is a pointer not only to genetic influences as well-known aetiological factor, but also towards a generally higher susceptibility to malformation genesis in a relatively small group of persons. Risk of recurrence was 0.5% if one parent was affected and 4% if a sibling was affected.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 2","pages":"72-7"},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042554","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13346517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial childhood achalasia.","authors":"M E Senocak,&nbsp;A Hiçsönmez,&nbsp;N Büyükpamukçu","doi":"10.1055/s-2008-1042561","DOIUrl":"https://doi.org/10.1055/s-2008-1042561","url":null,"abstract":"<p><p>Achalasia is infrequently reported in infants and children. It occurs exceedingly rarely in siblings. Only 33 cases of familial childhood achalasia were collected in the literature till 1987. Three definite cases and one suspicious additional case are presented and the aetiology is discussed.</p>","PeriodicalId":77648,"journal":{"name":"Zeitschrift fur Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft fur Kinderchirurgie = Surgery in infancy and childhood","volume":"45 2","pages":"111-3"},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2008-1042561","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13509901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}